The key objective of this guideline is to enable even the doctors working in Primary
\nCare Institutions as well as private practitioners to treat scorpion sting with confi dence.
\nEvidences suggest that doctors are not willing to make use of the medications and
\ndevices, even when available, due to lack the confi dence and guidelines. The present
\nhandbook provides guidelines to meet their needs, and outlines how they should proceedwithin their context and setting. The principles envisaged to treat scorpion sting at
\nall Health Centres \/ Hospitals irrespective of the status (Government or Private) are
\ngiven in Table no: 7 (vide supra under treatment) The initial evaluation and systemic
\nmanifestations following scorpion envenomation (described in Table 18, 19 and 20,
\nand Figure 1 and 2), and treatment aspects are provided in detail vide supra. However,
\na format for quick assessment is provided in Table 22 and 23 (refer Annexure VIII
\nand X).
\nTable No. 22: Initial evaluation of scorpion sting without
\nSystemic Envenomation
\nASSESS
\nVital signs
\n\u2022 Pulse
\n\u2022 BP
\n\u2022 Respiration
\nSYMPTOMS AND
\nSIGNS
\nLocal effects (Table 18)
\n\u2022 Sting marks and site
\n\u2022 Swelling and local
\npain
\n\u2022 Pain, erythema &
\nwheal
\n\u2022 Induration, macule\/
\npapule
\n\u2022 Progress to purpuric
\nplaque
\n\u2022 Local necrosis
\n\u2022 Lymphangitis
\n\u2022 Ascending
\nhyperesthesia
\n\u2022 Positive \u201cTap test\u201d
\n\u2022 Conscious level
\n\u2022 Any other systemic
\neffects
\nCLASSIFY
\nVital signs (Adult)*
\n\u2022 Pulse rate: 60-100\/
\nmin
\n\u2022 BP 110 \/ 70 to 140\/95
\n\u2022 Respiratory rate <20\/\nmin\nSYMPTOMS AND\nSIGNS\n\u2022 Local pain and\/ or\nswelling\n\u2022 Sting mark present\n\u2022 No other symptoms\nand signs\nIf the patient has\nabove fi ndings at the\ntime of assessment,\nclassify as No systemic\nenvenomation\nTREATMENT\nTab.Paracetamol\nInj.Tetanus Toxoid IM\nRoutine antimicrobials are\nnot necessary\nMonitor Pulse, Respiration\n& BP every \u00bd hourly for 3\nhours and every 4 hourly for\nremaining 48 hours.\nIf normal send the\npatient home\nIf the patient develops one or\nother systemic manifestations\nas described in Table 18, 19\nand 20, and Figure 1 and 2,\nproceed to treat as given in\nTable 23.\n*Vital signs for children (see age specifi c chart) are provided in Annexure III\n(Table No.30 to 33). If the patient has any systemic manifestations as described in\nTable 19 and 20, and Figure 1 & 2, proceed to manage as described in Table 23. The\ndetails of local envenomation is provided in Table 18.\nTable No. 23: Evaluation of scorpion sting with Systemic Envenomation\nASSESS \nVital signs\n\u2022 Pulse\n\u2022 BP\n\u2022 Respiration\nSYMPTOMS\nAND SIGNS\nIn addition to\nthose described in\nTable 22, look for\nthose mentioned\nin Table 19 and 20\nas well as fi gure\n1 and 2 for one\nor other systemic\nmanifestations as\ndescribed in Table\n19 and 20, and\nFigure 1 and 2.\nCLASSIFY \nVital signs (Adult)*\nPulse rate >120 per
\nminute, feeble (a
\nresponse to hypotension)
\nRespiratory rate > 20\/min
\nHypotension < 90\/60\nSYMPTOMS AND\nSIGNS\nSwelling and local pain\nIf systemic fi ndings\nare there at the time of\nexamination, classify as\nsystemic envenomation\nTREATMENT\n\u2022 Oxygen administration if\nrequired\n\u2022 Follow various principles\ndescribed vide supra\n\u2022 Start IV Normal Saline with\nwide bore needle as life line\n\u2022 Treat the patient with Tab.\nPrazosin (Plain)\n\u2022 Continue to monitor the vital\nsigns at fi ve minutes interval\nfor fi rst 30 minutes and then\nat 15 minutes interval for two\nhours.\n\u2022 For further details while using\nPrazosin follow the details\nprovided in Table No.21.\n\u2022 Stabilise the patient and\nrefer to the higher institution\nkeeping the patient in lying\nposture.\nFluid requirements per day should be kept in mind while managing the case.\nFor children readers are requested to see the fl uid requirement chart provided in\nAnnexure II.\n* Vital signs for children (see age specifi c chart) provided in Annexure III.\n\n<\/p>\n","protected":false},"excerpt":{"rendered":"
The key objective of this guideline is to enable even the doctors working in Primary Care Institutions as well as private practitioners to treat scorpion sting with confi dence. Evidences suggest that doctors are not willing to make use of the medications and devices, even when available, due to lack the confi dence and guidelines. […]<\/p>\n","protected":false},"author":3,"featured_media":0,"parent":63,"menu_order":0,"comment_status":"open","ping_status":"open","template":"","meta":{"footnotes":""},"class_list":["post-79","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/doctorbruno.info\/snake-bite-scorpion-sting-protocol\/wp-json\/wp\/v2\/pages\/79","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/doctorbruno.info\/snake-bite-scorpion-sting-protocol\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/doctorbruno.info\/snake-bite-scorpion-sting-protocol\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/doctorbruno.info\/snake-bite-scorpion-sting-protocol\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/doctorbruno.info\/snake-bite-scorpion-sting-protocol\/wp-json\/wp\/v2\/comments?post=79"}],"version-history":[{"count":0,"href":"https:\/\/doctorbruno.info\/snake-bite-scorpion-sting-protocol\/wp-json\/wp\/v2\/pages\/79\/revisions"}],"up":[{"embeddable":true,"href":"https:\/\/doctorbruno.info\/snake-bite-scorpion-sting-protocol\/wp-json\/wp\/v2\/pages\/63"}],"wp:attachment":[{"href":"https:\/\/doctorbruno.info\/snake-bite-scorpion-sting-protocol\/wp-json\/wp\/v2\/media?parent=79"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}